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[γ-干扰素释放试验与低剂量计算机断层扫描联合用于医护人员结核病筛查项目]

[COMBINED USE OF INTERFERON-GAMMA RELEASE ASSAY AND LOW-DOSE COMPUTED TOMOGRAPHY FOR TUBERCULOSIS SCREENING PROGRAM OF HEALTH CARE WORKERS].

作者信息

Nishi Koichi, Okazaki Akihito

出版信息

Kekkaku. 2015 Nov-Dec;90(11-12):683-7.

Abstract

OBJECTIVE

To evaluate the value of the interferon-gamma release assays and low-dose computed tomography for the pulmonary tuberculosis screenings program of health care workers.

DESIGN

For the pulmonary tuberculosis (TB) screenings program, T-SPOT.TB (one of interferon-gamma release assays: IGRA) were performed on 332 health care workers (HCWs) with normal chest roentgenogram and without the history of TB treatment. Low-dose computed tomography (LDCT) was also performed on IGRA positive HCWs.

RESULTS

Ten of 332 subjects were positive IGRA. LDCT was performed on IGRA positive 10 subjects. Abnormal findings were noted in 2 of 10 subjects by LDCT. One had CT findings compatible with active TB and finally diagnosed as active TB. Another had scarring shadow at right S5 and lingular segment. Nine of 10 IGRA positive subjects were judged as latent tuberculosis infection (LTBI). Three hundred twenty-one subjects with negative and borderline IGRA of 332 HCWs were judged as not infected with TB.

CONCLUSION

Combined use of IGRA and LDCT for tuberculosis screening program of HCWs was found to be effective for early diagnosis of TB, accurate diagnosis of LTBI and judgment of non-infective subjects.

摘要

目的

评估γ-干扰素释放试验和低剂量计算机断层扫描在医护人员肺结核筛查项目中的价值。

设计

在肺结核(TB)筛查项目中,对332名胸部X线片正常且无结核治疗史的医护人员(HCWs)进行T-SPOT.TB(γ-干扰素释放试验之一:IGRA)检测。对IGRA阳性的医护人员也进行了低剂量计算机断层扫描(LDCT)。

结果

332名受试者中有10名IGRA阳性。对这10名IGRA阳性受试者进行了LDCT检查。10名受试者中有2名经LDCT检查发现异常。1例CT表现符合活动性结核,最终诊断为活动性结核。另1例右肺S5段及舌段有瘢痕影。10名IGRA阳性受试者中有9名被判定为潜伏性结核感染(LTBI)。332名医护人员中321名IGRA阴性和临界值的受试者被判定未感染结核。

结论

发现联合使用IGRA和LDCT进行医护人员肺结核筛查项目,对结核病的早期诊断、LTBI的准确诊断及非感染受试者的判断有效。

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